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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1579553

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Case Details

VAERS ID: 1579553 (history)  
Form: Version 2.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC202100998300

Write-up: This is a spontaneous report from a contactable consumer received from the Regulatory Authority. Regulatory authority report number is GB-MHRA-WEBCOVID-202108040856409310-DSWWG. Safety Report Unique Identifier is GB-MHRA-ADR 25750434. A 40-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number not known, expiry date not reported), via an unspecified route of administration on 03Feb2021 as dose 1, single for COVID-19 immunisation. Medical history and concomitant medications were not reported. Patient had not had symptoms associated with COVID-19. Patient had not had a COVID-19 test. The patient experienced death on 04Feb2021. The patient died on 04Feb2021. It was not reported if an autopsy was performed. Case narrative: Patient had not tested positive for COVID-19 since having the vaccine. Patient was not enrolled in clinical trial. No follow-up attempts are possible. Information about Lot/ Batch number cannot be obtained.; Reported Cause(s) of Death: Death.

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